Experiencing an itchy scalp accompanied by hair loss can be both uncomfortable and concerning. While these conditions can occur independently, they are sometimes linked. It is normal to lose 50 to 100 hairs a day, according to the American Academy of Dermatology. However, it may be concerning when scalp itchiness is excessive or constant, you notice crusty areas on your scalp, or you experience more-than-normal hair loss. This article explores the various causes of an itchy scalp and hair loss, along with effective treatments and preventative measures.
People can often experience both an itchy scalp and hair loss, which suggests that these health issues may have a common cause or that one may cause the other. Although these conditions can occur independently, there may sometimes be a link between hair loss and scalp itching.
When a person scratches an itchy scalp repeatedly or intensely, they can damage their skin and hair follicles. This damage can result in temporary hair loss, bleeding, and scabbing from the scratching. Once the person stops scratching, the hair will usually grow back.
In other cases, such as hereditary hair loss or male and female pattern hair loss, hair loss occurs without scalp itching. In these cases, scratching the scalp may cause damage, but the underlying cause of the hair loss does not relate to the itchiness. Scratching will not affect whether or not a person loses their hair due to hereditary hair loss.
An itchy scalp and hair loss can be caused by a number of factors and can be a symptom of an underlying medical condition. Some skin conditions that cause an itchy scalp and hair loss are beyond your control. The following conditions and factors can cause both an itchy scalp and hair loss:
Read also: Dealing with Earwax and Itching
It’s generally thought that dandruff is the result of overactive oil glands on the scalp. This is why dandruff doesn’t usually develop until the teen years, when an influx of hormones kicks the skin’s oil production up a notch. Some researchers also speculate that dandruff (also called seborrhea) is caused by a yeast infection of the scalp and hair follicles. Besides inflaming the scalp and causing itching, yeast can weaken the hair root and lead to hair loss. Dandruff causes a dry, itchy scalp. A person can notice flaking skin throughout the day and after scratching. Scalp pruritus is most commonly associated with seborrheic dermatitis. Pathogenesis of seborrheic dermatitis is complex and appears to result from interactions among scalp skin, sebaceous secretions, Malassezia fungi, and the cutaneous immune system. Excess sebum production can also cause an imbalance in Malassezia on the skin. Malassezia is a type of naturally-occurring yeast that can cause inflammation and further damage to hair follicles if produced in excess and left untreated. There is no direct cause of seborrheic dermatitis, as this condition often develops in people who are otherwise healthy.
Hair loss with dandruff is rare, however. It only occurs when the dandruff is severe and left untreated for long periods of time. Treatment options include over-the-counter (OTC) anti-dandruff shampoos, ointments, and creams. A person can also apply natural oils, such as coconut oil, to the scalp before shampooing to help exfoliate the dead skin and flakes from the scalp.
According to the National Psoriasis Foundation, about 50 percent of people living with psoriasis develop scalp psoriasis. Psoriasis is an autoimmune condition that causes dry, red patches with a covering of silvery scales to form. Psoriasis scales can also develop on the scalp, and often, they can be itchy.
This condition may cause silvery, dry scales on the scalp, inflamed scalp, and hair loss that results from excessive scratching or pulling the scales off. Hair loss might occur if an individual scratches the psoriasis scabs on their scalp, and the scabs fall off. People can develop a treatment plan with a doctor to manage their psoriasis.
Alopecia areata is a condition that can cause all or patches of a person’s hair to fall out. It can also lead to scalp itchiness. Besides causing scalp itchiness and tingling, alopecia areata can cause tufts of hair to fall out. This can result in circular patches of baldness.
Read also: Causes and Solutions for Hair Loss and Itchy Scalp
“Alopecia” is a medical term for hair loss or baldness, and “areata” means that it occurs in small, random areas. There are many different classifications of alopecia areata. The classifications depend on the amount of hair you’ve lost and where you’ve lost it on your body.
Although scientists are not sure exactly why alopecia areata occurs, they believe it develops because a person’s immune system mistakenly attacks hair follicles. It most often occurs in people who have a family history of other autoimmune diseases, such as type 1 diabetes or rheumatoid arthritis. Anyone can develop alopecia areata. But your chances of having alopecia areata are greater if:
Alopecia areata is common. Nearly 7 million people in the United States have alopecia areata, and approximately 20% of cases involve children. Of people who have alopecia areata, 5% have alopecia areata totalis, and 1% have alopecia areata universalis. It’s the second-most common form of hair loss, behind female pattern baldness and male pattern baldness.
Alopecia areata causes your hair to fall out in patches. The patches are usually small and round - about the size of a quarter - but the shape and amount of hair you lose may be bigger or smaller. Your nails may also develop dents or pits (cupuliform depressions). They may make your nails feel coarse or gritty, like sandpaper. Alopecia areata doesn’t typically affect your physical health. However, it can affect you psychosocially (how society and social groups affect your thoughts and emotions) and psychologically (how you think about yourself and your behavior).
Also known as ringworm of the scalp, tinea capitis is a fungal infection that penetrates deep into the hair shaft, causing itchiness and hair loss. Ringworm is a fungal infection that causes a very itchy red rash in the shape of a ring. Ringworm and other fungal infections can weaken a person’s hair follicles, which can lead to hair loss.
Read also: Hair Loss Prevention
Depending on the type of fungi responsible for the infection, the hair may break off at the scalp’s surface or just above, leaving hair stubs. People with ringworm may notice distinct patches of hair loss on the scalp. The infection is highly contagious, is mostly seen in young children, and can also be accompanied by a raised, dry, scaly rash and black, bumpy dots on the scalp. Prescription antifungal creams can treat scalp ringworm, and the hair will regrow after treatment.
In severe cases, allergic reactions to things like hair dyes can cause an inflamed, itchy scalp and hair loss. Allergic reactions to hair products can irritate the scalp and hair follicles, resulting in itching. In most cases, the reactions are mild, and any scalp irritation or inflammation is temporary. However, if the irritation persists, it can damage hair follicles and cause hair loss.
In one study published in ISRN Dermatology,researchers found that up to 1 percent of the subjects were allergic to paraphenylendiamine (PPD), a common ingredient found in hair dyes. PPD is capable of causing severe hair loss in sensitive people. Inflammation and itching can also occur on the scalp around bug bites and can look like a rash or allergy.
People can have this type of allergic reaction to any product that they use on their hair, including shampoos, conditioners, hair dyes, hair gel, and hair mousses. A common cause of allergic scalp reactions is the chemical paraphenylenediamine, which is an ingredient in many dark hair dyes. Allergy creams or medications can often treat itchiness. If a product causes an allergic reaction, a person should stop using it and switch to a different product or brand.
Folliculitis is an inflammation of the hair follicles. It’s usually caused by staph bacteria or fungi. The infection can often cause itching and temporary hair loss. It can occur on your skin wherever hair grows, including the scalp. In addition to causing small, itchy bumps on the skin, folliculitis that affects the scalp can cause temporary hair loss. With proper treatment, the hair usually grows back. However, in rare cases, the condition can cause permanent hair loss.
Lichen planopilaris is an inflammatory scalp condition thought to be due to a faulty immune system. Lichen planopilaris is a condition that causes the scalp to become inflamed. Experts believe lichen planopilaris is the result of a weakened immune system.
It tends to occur in young adult women and can produce patches of hair loss along with scalp scaling, redness, burning, bumps, and blisters. The condition can cause itchiness, scaly skin, and hair loss. The hair loss can be permanent if hair follicles are irreversibly scarred.
Atopic dermatitis is a type of eczema that causes a red rash and itchiness. Although it is not a direct cause of hair loss, atopic dermatitis can lead to excessive scratching, which may cause temporary hair loss. People can treat atopic dermatitis using creams and ointments. A healthcare professional can provide advice on treatment options.
Research suggests a connection between stress and itching.
Treatments vary depending on the cause of the itchiness and hair loss. Your doctor may recommend:
Common therapies to treat hair loss include:
Medical News Today chooses products that meet the following criteria:
Below is a selection of products a person may wish to use to relieve itchy scalp.
According to the company, this product is suitable for people with dandruff and seborrheic dermatitis. The shampoo contains 2% zinc pyrithione, an effective treatment for dandruff. Many OTC anti-dandruff shampoos use it as an active ingredient. The company recommends using this product 3-4 times per week, or as a doctor directs.
Pros: This product contains zinc pyrithione, which is an effective dandruff treatment. Also, the shampoo is free from para-aminobenzoic acid (PABA) and sulfates.
Cons: Some reviewers state that they experienced hair loss while using this product. Others say the shampoo made their scalp drier than before.
The company states this shampoo treats and prevents dandruff and has an anti-inflammatory effect on any redness and itching. It also claims that the product’s targeted action treats the underlying cause of dandruff using its active ingredient, ketoconazole, which is a medication that treats fungal infections. Nizoral recommends working the shampoo into a lather and leaving it on the scalp for 3-5 minutes before thoroughly rinsing. It also suggests using this product 3-4 days for the first 2 weeks, then once every 1-2 weeks to prevent dandruff from returning.
Pros: This shampoo is cruelty-free, which means the company has not tested it on animals. Additionally, ketoconazole, the active ingredient, is effective at treating fungal infections.
Cons: The shampoo is not suitable for people with broken or inflamed skin or for everyday use.
This scalp treatment contains tea tree oil, witch hazel, and apple cider vinegar, which the company states may help soothe itchy scalp. The company recommends using this treatment 1-3 times per week. A person should apply it to their scalp and comb it through their hair, leaving it on the scalp for 5-10 minutes before rinsing thoroughly.
Pros: This product is cruelty-free and does not contain parabens or silicones. It is also one of the more affordable scalp treatments available online.
Cons: There is limited evidence that tea tree oil is effective at alleviating scalp itchiness.
When choosing products, a person may wish to consider the following:
If a person wants to prevent or treat hair loss or other hair-related issues, they should seek guidance from a healthcare professional, such as a dermatologist. They may recommend certain products or prescribe medication.
There are several at-home or natural remedies to treat conditions that cause itchiness and hair loss. Some methods to consider include:
Not every itchy scalp with hair loss needs medical treatment. Here are some things you can do yourself to ensure that your scalp and hair stay healthy:
A person should contact a healthcare professional if they experience any of the following:
Individuals should contact a healthcare professional prior to using any hair loss or scalp treatment.
There may be a connection between low vitamin and mineral levels and hair loss. A 2019 study found that low vitamin D levels may increase the risk of hair loss. However, the authors note that more research is necessary to determine the link between hair loss and low levels of iron, zinc, vitamin A, and biotin.
Scalp skin has a unique neural structure that contains densely innervated hair follicles and dermal vasculature. In spite of the recent advances in our understanding of itch pathophysiology, scalp itching has not been studied as yet. The sensory innervation of the scalp conducted through branches from the trigeminal nerve, cervical plexus and dorsal rami of the cervical nerves. The hair follicle (HF) is highly innervated with four types of specific nerve endings. These are: free nerve endings (nociceptors), lanceolate nerve endings (acceleration detectors), Merkel nerve endings (pressure detectors), and pilo-Ruffini corpuscles (tension detectors). The free nerve endings innervating the HF are from A-delta (thinly myelinated) or C fibers (unmyelinated) that emerge from the superficial nerve plexus. These nerves terminate as free nerve endings in the connective tissue between the sebaceous gland and HF.
Histamine is the prototype of endogenous itch mediator secreted from MCs and can induce pruritus via H1 and H4 receptors on NFs, whereas H3 receptors appear to be involved in the suppression of pruritus. Mast cells (MCs) can induce pruritus directly also through the release of other mediators such as chymase, tryptase and cytokines. MCs also secrete neurotrophins such as nerve growth factor (NGF) that contribute to hyperplasia of NFs in chronic pruritus forms, as has been observed in Atopic dermatitis (AD).
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